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Il Giornale Italiano di Radiologia Medica 2018 Luglio-Agosto;5(4):615-20

DOI: 10.23736/S2283-8376.18.00085-2

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: Italian

Onyx liquid embolic system for the treatment of peripheral hemorrage

Marco FEMIA ¹, Anna M. IERARDI ² ✉, Mario PETRILLO ², Salvatore A. ANGILERI ², Gianpaolo CARRAFIELLO ³

¹ Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Milano, Italia; ² ASST Santi Paolo e Carlo, Ospedale San Paolo, Milano, Italia; ³ Università degli Studi di Milano, ASST Santi Paolo e Carlo, Ospedale San Paolo, Milano, Italia

Ethylene vinyl alcohol copolymer or Onyx is an embolization agent increasingly used in peripheral interventional radiology. The Onyx Liquid Embolic System (LES) offers a liquid, non-adhesive, non-absorbable, injectable and permanent embolic agent. So far, it has been approved by Food and Drug Administration (FDA) only for the treatment of artero-venous malformations and intracranial aneurysms in the field of neuro-interventional radiology although its use is increasing among peripheral interventional radiology intra- and sometimes extra-vascular procedures. Onyx has more embolic predictability than other currently available liquid agents such as polyvinyl alcohol particles and N-butyl-2-cyanoacrylate as it is directly visible; moreover, it is possible to have a close control of the injection which can be stopped and restarted. Onyx has been already off-label used in many emergency bleeding settings (such as gastrointestinal, muscular, pulmonary bleedings, etc.) with satisfactory results. As it forms a cast within the vessel it stops the blood flow without the need of clot formation; this is why it is very useful in patients with coagulopathies or anticoagulation therapy, especially in critical situations. To summarize, Onyx seems to have a good potential in endovascular peripheral bleeding management. The aim of this brief article was to analyze the advantages of Onyx in the emergency setting on the basis of evidence in the current literature.

KEY WORDS: Embolization, therapeutic - Hemorrhage - Endovascular procedures - Onyx 18 - Onyx 34